超声乳化术中小瞳孔白内障虹膜环形切除

Circular Iridic Resection For Phacoemulsification In Small Pupil Cataract

探讨内源性及外源性葡萄膜炎导致的粘连性小瞳孔白内障更有效的手术治疗措施。方法 :对 12 4例 136眼小瞳孔白内障患者施行虹膜环形切除 ,再行超声乳化吸出白内障联合人工晶体植入。术后随访 1～ 6月。结果 :术后视力均有提高 ,裸眼视力 >0 8者 14眼 ,占 10 3 % ;>0 5者 5 6眼 ,占 41 2 % ;>0 2 5者 6 6眼 ,占 48 5 %。瞳孔均圆或椭圆 ,术后葡萄膜炎复发 9眼 ,2眼术后出现明显瞳孔区渗出 ,并形成纤维膜 ,术后角膜水肿 3例。结论 :此方法能使小瞳孔开大到一定程度 ,有利于实施超声乳化吸出白内障 ,且瞳孔括约肌不受损伤 ,避免术后眩光 ,可获良好的视力 ,减少术中、术后并发症。

Objective:To Investigate the surgical procedure of cataract with small pupil resulted from uveitis. Methods:On 136 eyes of 124 cases of cataract with small pupil,pupillary collar resection of iris had firstly been performed and then phacoemulsification and IOL implantation was done.Follow up was 1～6 months. Results:Postoperative vision had increased in different degrees.In 14 eyes(14%),the naked vision was more than 0.8,56 eyes >0.5(41.2%),66 eyes >0.25(48.5%).All pupils were postoperatively round or ellipse.Recurrence of uveitis after operation was seen in 9 eyes.There was postoperatively significant exudation in pupillary collar in 2 eyes,in whici fiber membrane formed.Corneal edema after operation was seen in 3 eyes. Conclusions:This technique can open up small pupil to a certain degree and was advantageous to the performance of phacoemulsification and IOL implantation without sphincter injury.Vision after operation has increased with few complications.